ASMBS support bariatric surgery for BMI < 35 patients

The American Society for Metabolic and Bariatric Surgery has issued a statement endorsing the use of bariatric surgery including gastric bands, sleeve gastrectomies and gastric bypass. The paper analysed evidence from 5 randomised trials and meta-analyses, as well as 16 observational studies.

The paper makes the following recommendations and observations:

Patients with a BMI between 30 and 35 have a well deﬁned disease that causes or exacerbates multiple other diseases, decreases the duration of life, and decreases the quality of life. These patients should be recognised as deserving treatment for this disease.

Current options of nonsurgical treatment for patients with a BMI between 30 and 35 are not generally effective in achieving a substantial and durable weight reduction.

For patients with BMI 30 to 35 who do not achieve substantial and durable weight and co-morbidity improvement with nonsurgical methods, weight loss surgery should be an available option for suitable individuals. The existing cutoff of BMI at 35 was established arbitrarily nearly 20 years ago. There is no current justiﬁcation on grounds of evidence of clinical effectiveness, cost-effectiveness, ethics, or equity that this group should be excluded from life-saving treatment.

Gastric banding, sleeve gastrectomy, and gastric bypass have been shown in RCTs to be well-tolerated and effective treatment for patients with BMI 30 to 35 in the short and medium term.